Usefulness of procalcitonin for diagnosis of infection in cardiac surgical patients
Usefulness of procalcitonin for diagnosis of infection in cardiac surgical patients
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DOI：
10.1097/00003246-200009000-00008
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发表时间：
2000-09-01
影响因子：
8.8
通讯作者：
Lehot, JJ
中科院分区：
文献类型：
--
作者：
Aouifi, A;Piriou, V;Lehot, JJ
Objective: To determine the value of procalcitonin (PCT) as a marker of postoperative infection after cardiac surgery.Design: A prospective single institution three phase study. Setting: University cardiac surgical intensive care unit(31 beds).Patients. Phase I: To determine the normal perioperative kinetics of PCT, 20 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass were included. Phase 2:To determine whether PCT may be useful for diagnosis of postoperative infection, 97 consecutive patients with suspected infection were included. Phase 3: To determine the ability of PCT to differentiate patients with septic shock from those with cardiogenic shock, 26 patients with postoperative circulatory failure were compared.Measurements and Main Results: Phase 1: Serum samples were drawn for PCT determination after induction of anesthesia (baseline), at the end of surgery, and daily until postoperative day (POD) 8. Baseline serum PCT concentration was 0.17 +/- 0.08 ng/mL (mean +/- SD). Serum PCT increased after cardiac surgery with a peak on POD 1 (1.08 +/- 1.36). Serum PCT returned to normal range on POD 3 and remained stable thereafter. Phase 2: in patients with suspected infection, serum PCT was measured at the same time of G-reactive protein (GRP) and bacteriologic samples. Among the 97 included patients, 54 were infected with pneumonia (n = 17), bacteremia (n = 16), mediastinitis (n = 9), or septic shock (n = 12). In the 43 remaining patients, infection was excluded by microbiological examinations. In noninfected patients, serum PCT concentration was 0.41 +/- 0.36 ng/mL (range, 0.08-1.67 ng/mL). Serum PCT concentration was markedly higher in patients with septic shock (96.98 +/- 119.61 ng/mL). Moderate increase in serum PCT concentration occurred during pneumonia (4.85 +/- 3.31 ng/mL) and bacteremia (3.57 +/- 2.98 ng/mL). Serum PCT concentration remained low during mediastinitis (0.80 +/- 0.58 ng/mL). Five patients with mediastinitis, two patients with bacteremia, and one patient with pneumonia had serum PCT concentrations of 10 ng/mL is highly indicative of a septic shock.
